Posters for 2025 POPS (Perioperative Care of Older People Undergoing Surgery) Meeting

INTRODUCTION Calcium-sulphate beads (CSB) are bio-absorbable antibiotic carriers which are used to manage surgical site infections as well as fill dead space. Iatrogenic hypercalcaemia from using CSB is a rare but potentially serious adverse effect. METHOD In this case report, we describe a patient who developed symptomatic hypercalcaemia secondary to using CSB during a Girdlestone excision arthroplasty. RESULTS An 86-year-old woman with a recent hip hemiarthroplasty for hip fracture developed a deep wound infection. Despite debridement and washout and prolonged intravenous antibiotics, her

Introduction: Frailty is common among older surgical patients and associated with poorer post-operative outcomes. Therefore, identifying at-risk patients for peri-operative optimisation is vital to improve surgical outcomes, yet national audits reveal it remains under-assessed (1). A review of a surgical ward showed that 0% of patients aged over 65 had a Rockwood Clinical Frailty Score (CFS) documented within 48 hours of admission. This QIP aimed to increase timely CFS documentation to 50% by January 2025 and 80% by June 2025 through structured interventions. Method: Following initial

Introduction The POPS (Perioperative medicine for Older People undergoing Surgery) service at Wye Valley NHS Trust has been established since August 2024. During this year, the service has been evolving, and we have been evaluating its impact. This has also involved working with NHS Elect through the POPS-SUp project. As well as the data we have gathered, during the past year there have been many learning points about starting a new service. Method Throughout this year we have used quality improvement methodology to help shape our projects, such as driver diagrams and statistical process

Introduction: With an ageing population, identifying frailty aids reduction of adverse postoperative outcomes. Centre for Perioperative Care - British Geriatrics Society ‘Care for People Living with Frailty’ guidelines state all patients aged >65 should have a documented Clinical Frailty Scale (CFS) score at pre-operative assessment. If CFS≥5, cognitive assessment should be documented and Comprehensive Geriatric Assessment performed. This audit aimed to assess frailty documentation at pre-operative anaesthetic assessment to support introduction of a specialist perioperative frailty pathway

Introduction Delirium is a recognised complication of emergency surgery and is associated with unfavourable clinical outcomes. Previous work has suggested that delirium is under-diagnosed. Here we describe risk factors for, and the clinical impact of delirium in an older-adult emergency laparotomy cohort. Methods Routinely collected data on emergency laparotomy patients ≥ 65 years admitted to The Grange University Hospital from November 2021 to April 2025 were included. Delirium was scored prospectively using the 4-AT score. Frailty was defined as Clinical Frailty Score (CFS) ≥ 5. Analysis was

Introduction Head and Neck surgery is complex, often requiring prolonged anaesthesia and careful postoperative care to ensure good functional recovery. The surgical pathway can be challenging for older patients living with frailty, who have longer inpatient stays and higher rates of postoperative complications and mortality. We have developed a new Geriatrician led service within the Head and Neck surgical pathway, which started in July 2024. This consists of a multidisciplinary outpatient preassessment clinic (geriatrician, anaesthetist and clinical nurse specialist) and weekly ward round

Introduction The perioperative journey for People with Parkinson's is a high-risk period. The current lack of unified guidance often leads to inconsistent care and unmet patient needs, despite advancements in Parkinson's disease (PD) diagnosis and long-term management. To address this gap, this qualitative study aimed to explore the lived experiences of people with Parkinson's undergoing surgery to inform our clinical guidelines for perioperative PD care that are currently under development. Methods Four patients, recruited from the Parkinson’s UK Patient Network, participated in the study

Introduction Reducing the time people wait for elective care is one of NHS England’s priorities. [1] It is projected that by 2030 there will be 1.4million Londoners aged over 65 [2] and increasing numbers of older people are undergoing surgery. [3] Frailty is a significant risk factor for surgical complications. [4] , [5] Non-electiveOrthogeriatrics is well established, this is not the case for elective orthogeriatrics or indeed other specialities The Centre for Perioperative Care (CPOC) and the British Geriatric Society developed evidence-based guidelines on perioperative care for people

Introduction Neck of femur (NOF) fractures in older adults result in significant morbidity, delayed mobilisation, and increased opioid exposure. Effective, early analgesia is essential for preoperative optimisation and enhanced recovery. Fascia Iliaca Block (FIB), especially when performed under ultrasound guidance (USS), offers targeted pain relief. This quality improvement project (QIP) aimed to increase adherence to RCEM guidelines on ultrasound use for FIB, thereby improving perioperative analgesia. Methods A closed-loop audit was conducted over two cycles (Cycle 1: November to December

The Surgical Frailty Journey – An Education Programme to Enhance Surgeon Confidence in Managing Frail Patients Introduction: Consultant surgeons of the future will need to manage patients with increasing levels of complexity and comorbidity as the population ages. National Emergency Laparotomy Audit (NELA) data highlights that patients over 70 constitute over 50% of emergency laparotomies, with frailty being a key determinant of outcomes 1. Previous surgical curricula have included recognition and management of frailty 2. Updated versions have deviated from such specifics, and surgical

Background: Falls are common among older people and are associated with serious sequelae, including hip fractures, physical injury, institutionalisation, and death. Data from the National Hip Fracture Database and the Trauma Audit and Research Network (TARN) reveal a significant financial liability for the NHS, driven largely by prolonged hospital stays. NICE guidelines recommend that all patients aged 65 and over should be routinely asked about any falls in the past 12 months during healthcare interactions. This practice is not consistently implemented during surgical admissions. Methods: A